UHC Approves Care for Short While
We know firsthand what this family is going through. It happened to us last summer when we were literally being told every Thursday of a decision to send Ryan home. For us, the most frustrating was were left in limbo to decided about renewing a lease. This life they are living is all too familiar to us.
It’s a travesty (and awfully cold-hearted) for this family that every two weeks it becomes another battle in an endless war. Yet, they did score a small reprieve. Thank you Team Diviney for helping them.Following is the email from Jane Martellino (Yes! Grace Rocks):
I do not expect you to post all of this. I just wanted you to get the update since you were so kind to rally your troops together. Since my young friend Grace suffered trauma to her brain from the brain tumor, I have been passionate about helping others and raising awareness of the fight these patients and families endure. Thank you and your team for lending their voice.
Here is Joseph’s mom’s update:
“I’ve explained it in previous posts in greater detail but the bottom line is Joseph meets the criteria for in-patient rehab UHC just doesn’t want to pay for it. It would be much cheaper for them to only pay for outpatient therapy but it isn’t even comparable to the quality of therapy he’s getting at TIRR let alone how impossible it would be in managing Joseph as a totally dependent patient in an out-patient environment. The Medical Director said that they were concerned that Joseph’s “FIM” (Functional Independence Measure) score was the same as it had been since his admission. Dr. Tastard explained to him that you can’t use that measure on brain injured patients as they are not going to progress like other patients in a rehab hospital who have a spinal cord injury, hip replacement or other injury. Joseph is a long way from showing independence for goodness sake. His entire brain was severely injured!
TBI injuries take time to rehabilitate!!! Dr. Tastard told the Medical Director from UHC that all Joseph’s therapists had been providing very detailed documentation of his progress instead of the standard “check a box” system in order to give UHC a thorough report on his progress since the FIM is not an appropriate scale for TBI patients. In the end the Medical Director’s comment was “well, let’s speak again on May 18th meaning Joseph’s been approved until then. Dr. Tastard thanked Rob and I for staying the course not just for Joseph’s sake but for all TBI survivors because too many are kicked to the curb without family able to go to bat (or should I saw WAR?) for them.”